One of the causes of falling due to turning of head in elderly people

Elderly woman (Credit: Matt's Sketch pad)

Elderly woman (Credit: Matt’s Sketch pad)

Main Point:

Researchers have found that head-turning, irrespective of the direction of the head movement, results in hypotension in over one-third of patients and over two-fifth of healthy elders, leading to falls.

Published in:

PLoS ONE

Study Further:

Falling in elderly people:

Falling is one of the conditions resulted from decreased blood pressure (hypotension) in elderly people. Usually carotid sinus hypersensitivity causes hypotension, dizziness or fainting episode resulting in falls and rotation of the neck is thought to cause carotid sinus hypersensitivity.

According to researchers, 30% of those aged 65 years and older fall at least once a year.

Hypotension:

Hypotension refers to the low blood pressure and in the present study “Head turning-induced hypotension was defined as a drop in systolic blood pressure of at least 20 mmHg during head turning.”

Carotid sinus hypersensitivity:

In carotid sinus hypersensitivity, baroreceptors – nerve ending that are sensitive to blood pressure changes – in the carotid sinus – a dilated portion of one of the major arteries supplying blood to the head – are thought to be highly irritable as a result of factors such as external manipulation or pressure resulting in false hypertension detection leading to rapid decline of blood pressure due to baroreflexes.

Research:

In the present study, researchers worked on 105 elderly patients and 25 healthy elderly subjects. They checked the blood pressure and heart rate of the individuals before, during, and after head turning.

Researchers have found that head-turning in any direction resulted in hypotension in 39% of patients (mean systolic blood pressure drop 36 mm Hg) and in 44% of the healthy elderly. They found that carotid sinus hypersensitivity was linked to the head-turning induced hypotension.

Researchers have also reported that turning of head is related to vasodepression – decrease in vascular resistance with decrease in blood pressure – and is not linked to bradycardia – slowness of the heart rate, usually measured as fewer than 60 beats per minute in an adult human.

Researchers are of the opinion that the elders must have to be advised to minimize extreme head turning as it may result in falls.

Distribution of maximal systolic blood pressure drops due to head rotation in the patient group. (Credit: Schoon et al.,/PLoS ONE)

Distribution of maximal systolic blood pressure drops due to head rotation in the patient group. (Credit: Schoon et al.,/PLoS ONE)

References:

Carotid Sinus HypersensitivitySyncope

Yvonne Schoon, Marcel G. M. Olde Rikkert, Sara Rongen, Joep Lagro, Bianca Schalk, Jurgen A. H. R. Claassen (2013). Head Turning-Induced Hypotension in Elderly People PLoS ONE DOI: 10.1371/journal.pone.0072837